Individual
ANGELA J. VICKERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1625 STOCKTON BLVD, SACRAMENTO, CA 95816
(916) 262-9108
(916) 262-9109
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(800) 470-0071
(916) 736-6798
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
33100036
CA
174400000X
Specialist
Primary
G65356
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G653560
—
CA
Enumeration date
10/13/2006
Last updated
05/22/2015
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